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SAN JOAQL LN COL?�i i� E`N'RO?ti� EEN, -kL �E-1,L7H DIVZSMN <br /> ME r!- A.LTH .4ti7D SAFETY PLA N <br /> .. i PART II <br /> C-EMEFLAI lir. IN-FORMA=ON + r-VALUA=ON OF POT?v uAL F-:AZARDS <br /> _. Site Name: r7��Gli' l aNS 1. Chemicals 'r'_ards <br /> Address: _ iy S: IWAN`4 [<] Czrcnoger.s: <br /> Contac Person: Phone No. x Carrosives: <br /> Swee?s Number. EA Duszs' <br /> Proposed Dare of invest;gadon.A=ec on: 06 P;�losives: <br /> (A _,a=x aisles: <br /> 2. Descipdon and 'brief na.t-aLive of inspec--+on acr*viLy: [ ] [aorganic Cases: <br /> ( 1 New liS 1 i^ 1 anon [ ] UA.R Iaverg-arion [ I Memis: <br /> [ 1 Tank Ciosu-e �- place ( ] Tanlc/P:pe Repair [ ] Oxidizers: <br /> [ ] zmV.i-pe RP.�oval (� . NhZ WAs78 ln1tP. (] ?C 's: <br /> [ ] i^stzlanon of Borrgs/Mordtorrg Wells <br /> 3. Soe-'^c Site Lror=ario= REQTJ-= pVRSONA.L PRO==CTEVE <br /> -_ k No. 'zn c Capacry E'QUEPma <br /> T ark Co=e---rs: <br /> vL'1°_'': '_. MonStbr'T'� -?L=1DIIe•^-C (IIDt2: �D'L'LDL? � <br /> must be used for aL, ope_a_ons <br /> Type of Cpe_^anoc umless approprate rat_onaie are <br /> TJrovided) <br /> S. <br /> R--i--ase Fistorj [ ] Combuseble Cts/Or .ae M-ye_e_- <br /> 'riderce of leaks/soil car-=E inarion: [ I ES [ I NO [ ] Derecor lubes (Soecfl) <br /> ] Phoroioni-,=on Detecor <br /> Doc��.^red GrDLdwaL�� cori*...�minacot:: f j YES [ j v0 [ �� oT <br /> Back, and desc:ptioII of aay previous `roves 49=On [I Or otic Vapor. .a yz` <br /> [ i Otter, specify: <br /> or incidence: <br /> If,Z'On1LD.^yg ins—_=e=rs Zre zoc _se^_, <br /> mr onale or ac:i ry/area reser:c=ons: <br /> 5. Poceazal ealta and Safer/ <br /> ?j:ysicmj Conc_^z: (c er_'f ail djar anpiy & desc:oe) <br /> o'' ai a�ie��temD_) <br /> Lt:ear or Coid Suess: C � _ <br /> Noise Sourca: 2 Personal Procec.'ve EgLnpme= [ 1D <br /> '� Level of Prose=o= []A [ IB [ 1C <br /> [ i Oxygen DehcerC/ <br /> u Ds ,siiPpin cave-ids) X :?Sd IIar <br /> gi <br /> [ ] =;C34aL'OL1: (rails, g, <br /> angling and T.�nsfe: of arazardous Substance: (�c] Safety basses/goggies <br /> r�ra er�iosiors ere bc] Steel coed/shank shoes or boors <br /> [ 11Coadned Space enz� (emiosions) [ ] rsame retardant cove-a.s <br /> f)(] -ezvy eauipmerL Cal r & —,,a ^a resulting [� :-:e'-L'•ng?LoteCDII <br /> CPQ � [ ] T�e>i <br /> om =oving ecuip=er'L) <br /> [ ] _Respirator, C rce: i or SC3A <br /> Other, spe�ry IMWWbt-N ?JP c -d- — <br /> [ II Safe y vest <br /> Anticipated 1 hri Nb Two-way cDr^a..^ nic riot! <br /> 7. LcpaL_d 3iologic-=. 'r"a�.s: <br /> [ j Snakes [ 1, L--sects f ] Rodents [ ] Poisonous plants <br /> [ ] Oc er/Unimo� (sue^iy): p aRT IV <br /> PLAN APPROVAL <br /> &NNa_T--arive (provide alU1 inor._.atien wnica could iI=ac Health <br /> and Safery, e.g., ?ower 1 res, inre�'y of d£�ces, re-mr. ere): pizn ?re?aced by PILI � Dare: <br /> ?laraDoroved by Date: <br /> :—.L o3081 (2/7/92) <br />